Michael F Grisanti III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39641 Issued in CA

Practice address

2855 Telegraph Ave
Suite #103
Berkeley, CA 94705-1128

Phone

(510) 549-8720

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548319700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SERRA CT",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496150",
            "telephone_number": "415-382-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 TELEGRAPH AVE",
            "address_2": "SUITE #103",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947051128",
            "telephone_number": "510-549-8720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISANTI",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisabeth P Griffinger-Guidi, CNM
• Deborah Lee Griffith
• Jane Griffith, PT, DPT
• Wayne Lee Grigsby, CADAC
• Carol Deborah Grimm, D.D.S.
• Steven Grolnic-McClurg, LCSW
• Tamra Leigh Groode, NP
• Sebastian Orion Groot, D.O.
• Groove Medical Group PA
• Elizabeth Patricia Grosel

• General Practice Dentistry in Berkeley, CA
• Providers in Berkeley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.